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Background The study on eye surface damage following phacoemulsification with intraocular lens (IOL) implantation is increasingly concerned,and these symptoms were associated with dry eye and often treated by polyethylene glycol eyedrops to remit the discomfortableness.Recombinant bovine basic fibroblast growth factor (rb-bFGF) eyedrops contains neurotrophic factors, but its effect on eye surface damage is worth researching.Objective This study was to evaluate the repair effects of rb-bFGF on ocular surface injury after phacoemulsification with IOL implantation.Methods A randomized controlled trail was designed.Ninety eyes of 72 consecutive patients with age-related cataract were enrolled in Fenyang Hospital of Shanxi Province from September 2010 to August 2013 under the informed consent.Phacoemulsification with IOL implantation was performed on all the eyes, and tobramycin and dexamethasone eye drops was used for 15 days as basis therapy.According to the treatment sequence,the operative eyes were assigned to rb-bFGF eyedrops group, polyethylene glycol eyedrops group and basis therapy group.rb-bFGF drops and polyethylene glycol drops were topically administered 4 times per day since the first day after surgery for consecutive 30 days in corresponding group,and only basis therapy was maintained in the basis therapy grouply.Corneal fluorescence (FL) staining scores,breakup time of tear film (BUT) and Schirmer Ⅰ test (S Ⅰ t) without topical anesthesia were examined in 1 day before operation and 1 day,7 days, 15 days and 30 days after operation.The efficacy was intergrouply compared.Results No significant differences were seen in the demography and the relevant surface examinational outcomes among the rb-bFGF group, polyethylene glycol drops group and the basis therapy group before surgery (age : F =1.50;gender :x2 =0.336, both at ＞ 0.05;FL : F =0.31;BUT:F =0.65;S Ⅰ t: F =0.57;all at P ＞ 0.05).Compared with the before operation, FL scores were obviously increased,and BUT values were reduced and S Ⅰ t values were elavated in all the eyes early stage of surgey and then gradually improved with the lapse of postoperative time, showing significant differences (Ftime =7.83,7.32,7.17, all at P＜0.01).The FL scores,BUT and S Ⅰ t in 15 days after surgery in the rb-bFGF drops group and 30 days after surgery in the polyethylene glycol drops group was closed to those of before surgery (all at P＞0.05).However,there were still significant differences between the before and after operation in the basis were closed to those of before surgery therapy group (all at P＜0.05).In addition, significant differences were found in corneal FL scores, BUT and S Ⅰ t among these three groups (Fgroup =5.08,4.15,4.61, all at P＜0.05).In postoperative 15 days and 30 days, the S Ⅰ t values were (12.32±1.18) and (11.32±1.98) mm/5 rmin,which were significantly lower than (14.36±1.77) and (13.36±2.32) mm/5 min in the polyethylene glycol drops group and (17.25 ±2.24) and (13.25 ±2.53) mm/5 min in the basis therapy group (all at P ＜ 0.05).Conclusions The topical application of rb-bFGF combined with tobramycin and dexamethasone eyedrops can improve the dry eye-related symptoms and promote the repair of the ocular surface injury after phacoemulsification with IOL implantation,and the clinical efficacy of rb-bFGF eyedrops is better than that of polyethylene glycol eyedrops or only tobramycin and dexamethasone eyedrops.
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Background Prevalence of dry eye is significantly inceasing in postmenopausal women than that in men,suggesting that sex hormone plays a role in the pathogenesis of dry eye.In addition,dry eye might become worse following estrogen therapy in postmenopausal women.However,whether application of androgen can ameliorate dry eye is being concerned.Objective This study was to investigate the effect of androgen on tear film of ovariectomized female rats.Methods Forty-eight 3-month-old sexually mature female Wistar rats were randomized into the normal control group,sham group,ovariectomy (OVX) model group and testosterone-injected group.OVX models were established by bilateral ovaries enucleation in the rats of the model group and testosterone-injected group,and then androgen (3.75 mg/kg) was intramuscularly injected since 5 months after OVX at 3-day interval for 6 weeks.Only intraperitoneal fat was cut off in the sham group.In 6 weeks after injection of androgen,serum androgen concentration detected and Schirmer Ⅰ test (S Ⅰ t),tear film break-up time (BUT) were performed.The rats were sacrificed to prepare the corneal and conjunctival samples.The expression of MUC5AC in conjunctival tissue was examined by immunofluorescence staining,and the microstructure of corneal cellular surface was observed under the scanning electron microscope before and 6 weeks after application of androgen.Animals in this study were treated in accordance with Animal Experimentation Ethic Committee Guidelines of Southern Medical University and the study protocol was approved by Ethic Committee of this University.Results The mean serum testosterone concentration was (1.83 ±0.12) ng/ml,and S Ⅰ t or BUT was (3.63-±0.26)mm/5 minutes or (3.73-0.38) seconds,respectively,in the OVX model group,which was significantly declined in comparison with (2.56 ±0.14) ng/ml,(7.47±0.66) mm/5 minutes or (9.57 ±0.76) seconds in the normal control group (all at P =0.000).However,the serum testosterone concentration was (3.38±0.24) ng/ml,S Ⅰ t was (6.37 ±0.45) mm/5 minutes and BUT was (7.54±0.55) seconds in the testosterone-injected group,which was significantly higher than that in the OVX model group (all at P =0.000).The positive staining of MUC5AC in rat conjunctival tissue weakened in the OVX model group compared with the normal control group,and the fluorescence intensity in the testosterone-injected group was stronger than that in the OVX model group.Regularly arranged microvilli and cell metabolism hiatus on the surface of corneal cells were seen in the normal control group and the sham group;while the microvilli were shorter and irregularly arranged,and the cell metabolism hiatus were disappeared in the OVX model group.However,microvilli and cell metabolism hiatus were close to normal ones in the testosterone-injected group.Conclusions Deterioration of tear secretion and instability of tear film are are probably associated with the lower serum androgen levels in castrated female rats.Systemic supplement of androgen can promote tear secretion,improve tear film stability and alleviate ocular surface damage.
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Dry eye is a group of multifactor-induced ocular surface symptoms.The conventional therapy for dry eye is to increase the tear passively,such as topical administration of artificial tears eye drops and blockage of lacrimal punctum.However,with a better understanding of pathogenesis of dry eye,it is thought that an ideal method for dry eye is to promote the secretion of tear.Studies showed that P2Y2 receptor agonists can promote the lacrimal gland to secrete tear actively.Up to now,multiple synthetic P2Y2 receptor agonist mimics have been studied,and these studies confirmed that these drugs can improve the secretion of not only water-like tear but also mucoprotein,which can alleviate symptoms in patients with dry eye.In addition,good safety also is clarified by clinical trial of phase Ⅰ.This review briefly summarize the researches on active mechanism,clinical efficacy and applying prospect of P2Y2 receptor agonist for the treatment of dry eye.